Medical review

Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically reasonable and necessary.

This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for major hip and knee joint replacement or reattachment of lower extremity (…

View TPE round results for drugs and biologicals (HCPCS J7318-J7329, J7331-J7332).

View TPE round results for drugs and biologicals (HCPCS J7318-J7329, J7331-J7332).

This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for emergency ambulance transports.

This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for other musculoskeletal system and connective tissue or procedures (DRG 515,…

This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for outpatient hospital services.

This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests pertaining to diagnostic radiology.

Background Submissions Extended affirmation periods

This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests pertaining to diagnostic radiology.